Jan 19, 2016
By: Kathy Yanchus
The province has committed $2.7 million over the next three years in an effort to improve emergency room wait times at Joseph Brant Hospital.
The financial investment is designated for a General Internal Medicine Rapid Assessment Clinic or GIMRAC, to be staffed by a multi-disciplinary team of physicians, nurses, physiotherapists, social workers, dietitians and pharmacists. The clinic will be located adjacent to the emergency department and is scheduled to open in the spring.
“It’s all about the right care, at the right time, at the right place and triaging people who come into the emergency department, ensuring acute care patients get the emergency care that they need,” Burlington MPP Eleanor McMahon, told the Post Tuesday.
“The emergency department is not the catchall for all patients and we’re trying to re-route people out of there to allow the emergencies to have better access to testing, to beds, etc.,” said Dr. Wesley Stephen, JB’s chief of staff.
“This is not a new concept; this is a concept of best practice and many organizations have found this very useful in helping the flow in their emergency department.
“We’re really targeting two general populations,” said Stephen. “The first one is the patient who presents to the emergency department who actually may not need an admission and would be urgently seen within a day or two by a general internist who would be managing their clinical situation as an outpatient or in a home setting rather than in a hospital bed.
“And the second group of patients are actually people that would be discharged from hospital, that we may actually be bringing back early for a follow-up visit at the hospital through this clinic, to avoid re-admissions.”
The net effect is less pressure on hospital beds and improved flow through the emergency department, said Stephen.
“With less congestion in the emergency department I think people would feel that they’re getting much more attention and their access to the resources of the hospital would be better if there’s not a lot of people in the emergency department.”
Stephen estimates that approximately 1,500 patients yearly might avoid admission to the hospital with their care managed as an outpatient in the GIMRAC.
For example, a patient who presents with what is determined to be non-life-threatening chest pain and is well enough to go home can be assured of follow-up care at the clinic.
“It could be rapidly determined that they’re actually not having a heart attack but what they need is a follow-up consult with the internal medicine specialist, and they need a consultation with a dietitian….,” said McMahon. “So we need to get them out of the emergency room and not only triaged appropriately, but their follow-up care is appropriate, so we’re not seeing them back at the emergency department two days hence.”
From a psychological point of view, GIMRAC will be a “real enhancement for the community and I think people will be very appreciative they will get access to timely healthcare,” added Stephen.
Other medical issues that could be treated in the clinic might include diabetes or bladder and urinary tract infections, he said.
“Some of these people have other complex issues so having a multi-disciplinary team, we could address various issues as well,” said Stephen.
Every hospital in the province has struggled with their wait times in their emergency department; JB is not unique, said McMahon.
JB’s GIMRAC is a significant component in improving emergency room wait times but it’s not the only solution, said Stephen.
It’s one step in meeting or exceeding the emergency department wait times as set out by the province and the LHIN, he added.
Both Hamilton Health Sciences and St. Joseph’s Healthcare in Hamilton operate similar clinics and both have improved patient flow, said McMahon.
An official announcement of the new provincial funding was made today.